This common cosmetic surgery procedure aims to remove excess skin and fat from the lower abdomen and improves the profile of the waist area.
There are generally 4 types of abdominoplasty procedures
Where there is only slight skin excess, frequently hanging over a tethered caesarean section scar. This operation is performed as a daycase procedure. Skin above the belly button is left untouched as is the belly button itself. Liposuction can also be carried out, usually above the bellybutton and the flank areas.
After taking a thorough history, you will be examined to assess the amount of excess skin and fat that requires removal, and one of the 4 procedures described above will be recommended. I will explain to you in detail what can be achieved and aspects that will remain unchanged after surgery.
All the procedures described above are performed under a general anaesthetic. The operation takes between 1 and 3 hours depending on the procedure. Scars are hidden in the natural creases of the skin, aiming to be below the bikini line. Because the belly button has to be re-positioned, there will be a small scar around the belly button that fades well over time. If there is separation of the central abdominal muscles (divarication of the rectus muscles), these will be tightened using permanent sutures. Apart from the mini-abdominoplasty, I use one or two drains and you will stay in hospital for one night, occasionally 2 nights. The drains are removed before discharge. You will be placed into a garment to maintain gentle compression on the abdomen. The sutures are all absorbable and the dressings are shower proof.
It is common to have some bruising and swelling post operatively. This is more obvious if the operation includes liposuction. This settles over a few weeks. The final shape may not be seen for at least 6 months after surgery. Please remember that any change in your weight will impact on the shape of your abdomen, even after surgery.
Plenty of local anaesthetics is used during the operation while you are asleep. This means that following surgery, there will be minimal discomfort for the first few hours. Thereafter, a standard regimen of painkillers usually suffices for most people.
Any operation involving a general anaesthetic carries a risk of developing blood clots in the calves (deep vein thrombosis – DVT), which could break off and move to the lungs causing a pulmonary embolism (PE). Early mobilisation and keeping hydrated will reduce this risk, as will avoiding smoking before and after surgery for at least 6 weeks. There is a risk of allergy to the drugs for anaesthetic and antibiotics/pain relief, and a very small but theoretical risk of major life-threatening complication/death related to the anaesthetic (1 in 100,000 risk).
Sleeping: Sleep on your back with one or two extra pillows under your head during the first 2 weeks, as this will help to reduce swelling. Additionally, you should have a pillow under your knees so the hips are slightly flexed. This takes the strain off the wound.
Work and leisure activities: It is recommended that you take 2 weeks off work. Avoid swimming, the gym or strenuous activities for 6 weeks.
Diet: Maintain a healthy nutritious diet with plenty of fruit and vegetables, as this is important for wound healing and comfortable bowel movement.
Flying: Avoid flying for the first six weeks, wear flight socks and take low dose aspirin (75mg) before flying. Additionally, if there are any major problems, I would like to be able to see you within those 6 weeks.